Thursday, 30 July 2020

Time's running out: HRA edition

Our friends at FlexBank (now Flexbank/Navia) have a timely reminder for employers with Health Reimbursement Accounts (HRA's):

"Don't forget! The HRA PCORI fee is due by July 31, 2020"

As in: tomorrow.

This year's fee is about two-and-a-half bucks per participant, and it's due no later than tomorrow (July 31).

Oh, and just what is this fee?

"[T]he Patient-Centered Outcomes Research Institute, which "funds studies that can help patients and those who care for them make better-informed healthcare choices."

Okay, thanks for clearing that up.


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Wednesday, 29 July 2020

Timing & LTCi

A few years back, I ran into a colleague at the grocery. She had recently been licensed to sell Long Term Care insurance, and wanted to "talk shop."

Okay, I’m all ears.

Turns out, she had been trained (??) to advise her clients to put off filing a claim for as long as possible, on the theory that using their own funds would allow the insurance dollars to last longer.

I nodded and said "well, that’s interesting," and we went our separate ways.

It was not, in fact, "interesting,” it was stupid.

Whoa there, Henry them's sharp words. Care to 'splain’ yourself?

Sure.

Last Fall, my mother-in-law was in a pretty nasty car wreck, and ended up in a very nice  Assisted Living facility. She had long ago bought a Long Term Care insurance policy through an affiliate program that her husband's employer offered. Since she had multiple physical issues as a result of the accident, she qualified for benefits under the policy, and they began rolling in a few months later.

Unfortunately, she passed away recently, which is what prompted this post.

The most important aspect of the claims issue is that we don't know how long that person will live, and had we listened to my colleague's advice, we may well gave left significant "money on the table." Here's why:

She needed help with activities of daily living, and part of the claims process is an evaluation by a company representative (usually a nurse of service that they contract with) to make that assessment. If we had waited, there would have been no way for that evaluation to have taken place, and the claims process would have been very messy (or jut straight-out declined). There was absolutely no upside to waiting, but significant potential (more likely, probable) downside.

Alternatively, had she been cleared for claims up-front and we had simply waited before filing the claim (which is another way to have interpreted my colleague's idea), we would not have been reimbursed until later. Yes, we would likely have still received the funds (this was a reimbursement-type plan) but why would we have given up the interest (this was a fairly decent amount)? After all, money is fungible, and using the carrier's funds instead of Mom's meant her money was able to keep earning interest.

Take heed.


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Tuesday, 28 July 2020

COVID & BI: One more time...

We last discussed this issue a couple months ago:

"It's going to perhaps send a false sense of hope and promise to a community of folks who need action and relief now."

That was in response to a threat by DC Council-critters to force carriers to pay Business Overhead (BI) claims for quarantined businesses. Regular readers know that this coverage does not extend in that circumstance.

Fast forward a bit, and we get this in email:

"The ruling reaffirms that BI policies only cover physical damage."

That is, the closing of a business due solely to government mandate, with no actual physical loss, is not a covered BI expense.

This is important because it's one more nail in the proverbial BI/COVID coffin.

Click on through for the gory details.


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Monday, 27 July 2020

Kind of Off-Topic, but...

This is pretty amazing:

"2nd baby is born from dead donor's transplanted womb at Cleveland Clinic"

Most of us are familiar with posthumous organ donation (heck, there's even a checkbox on drivers' licenses), but I daresay that likely includes corneas and kidneys, hearts and lungs, that kind of thing. I've even heard of harvesting sperm from a dying father.

But this one is new to me. And it gets even more interesting:

"It's the second child in the hospital system to be born from a dead donor's transplanted womb." [emphasis added]

Wow - And Mazel tov to Mom!

[Hat Tip: Holly R]


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Friday, 24 July 2020

From the folks in DC

Comes this helpful video on how to report federal pandemic unemployment compensation. Although it's geared for agents, seems perfectly suitable (and informative) for consumers, as well:



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Thursday, 23 July 2020

This is Weird: Revisited

The other day, Hank posted on the difficulty he was having reconciling why a given person's group health insurance rate changed depending on whether they were the employee or the employee's spouse. That post, and some back-and-forth in the comments, sparked my curiosity. 

Hank said

"up until about age 40, the male spouse rate is actually lower than the male employee rate. And at age 35,female employees are actually more expensive than their(presumably) stay-at-home counterparts."

So I graphed the data based on the original post.

1.  Male employee vs male spouse
2.  Female employee vs female spouse

Graph #1 addresses the first reference above (click to enlarge):



The premium rates differ in specific amounts, but the differences are not material below age 50.  After age 50 the spouse rate rises above the employee rate.  This insurance company apparently has data that support the higher cost for older male spouses vs older male employees.  I’m guessing that older male spouses tend to have more health conditions that prevent them from working.  That would show up in the experience of the pool, and its effect would likely grow as the individuals age.

Graph #2 addresses the second reference:




The main difference in this graph vs. Graph #1, is seen in ages under 35.  My guess is that the female spouse rate is higher than the female employee rate through these younger ages because of marginally higher maternity liability.  That difference then closes rapidly.   After age 54 the female spouse again appears to be more costly.  Again, I don't dispute that the insurer’s cost data support the differences.  After taking maternity into account, the result observed in Graph #2 is consistent with the result observed in Graph #1.   It may well have the same origin i.e., that older female spouses tend to have more health conditions than older female employees, that prevent them from working.

Another possibility is that this insurance company’s pool includes marginally more male spouses who are employed (under age 50, anyway), and therefore represent a lesser liability to the female employee's plan because of COB (Coordination of Benefits).

Whatever, and aside from the actual dollars-and-cents differences in rates, the shapes of the lines on the graphs seem to me consistent.

I think the actuarial correspondent is correct about the beneficial effect of selection for employees vs spouses.  It’s visible in the premium rate relativities in all the other premium rate graphs I created (see PS, below).   I'm surprised he did not mention (or maybe he did?) the cost of maternity for younger females, regardless whether working or not.  That’s visible in the graphs, too.

In each of the questions you’ve raised. I’m not claiming I have a full explanation.  While I think my guesses may be a good part of the explanation, we’re still left with questions.

"We started with one question, and ended up with many questions."  One of my profs in college (philosophy, not mathematics) often made that remark at the end of his lectures - and then always concluded by saying "What a marvelous bargain!"    I still think that insight was worth the whole semester's tuition.  At least for his class.  (In 1965, the undergraduate tuition at my school for a 3-hour class was only about $150).

Which means - - this exercise was a bargain!



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